Modified Orbitozygomatic Approach for Resecting a Parasellar Tumor in a Single Institution

• Published in: Brain tumor research and treatment Vol. 9; no. 2; pp. 58 - 62
• Main Authors: Jin Gu Kim, Dong Hoon Lee, Young Il Kim, Il Sup Kim, Jae Hoon Sung, Seung Ho Yang
• Format: Journal Article
• Language: Korean
• Published: 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 31.10.2021
• Subjects: Craniotomy; Meningioma; Orbit; Pituitary adenoma; Skull base; Zygoma
• ISSN: 2288-2405; 2288-2413

Background Modified orbitozygomatic craniotomy is characterized by simplicity and wide exposure. The purpose of the present study was to describe a modified orbitozygomatic approach without resecting the zygomatic arch for large parasellar tumor surgeries. Methods Between April 2016 and December 2019, seven patients with parasellar tumor underwent surgiest with a modified orbitozygomatic approach. Surgical procedures, clinical outcomes, and complications were analyzed. Results This study included 3 meningiomas, 2 pituitary adenomas, 1 chondrosarcoma, and 1 schwannoma. Modified orbitozygomatic craniotomy provides a wider surgical freedom in the opticocarotid and prechiasmatic cistern than frontotemporal craniotomy without orbitotomy, Total, subtotal, and partial resections were achieved for 3, 2, and 2 patients, respectively. Reasons for partial resections were tight adhesion to the carotid artery and encasing of the carotid artery. Permanent morbidities developed in one patient with 3rd nerve palsy and one patient with hemiparesis. Conclusion Modified orbitozygomatic approach can provide the shortest access to the interpeduncular cistern with a minimum brain retraction. Surgeons who experience surgical challenge during the conventional approach for parasellar tumor resection are recommended to learn the modified orbitozygomatic approach.